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Haiti

International Women’s Day, March 8, signifies more than a single day can encompass. At MSH, International Women’s Day is a day for celebrating women health leaders who inspire change and an opportunity to recommit ourselves to another year of action toward gender equity.

We pay homage to the women who have come before us; we stand on their shoulders. We acknowledge their courage, sacrifice, and commitment, allowing women today to dream of a future with more possibilities for next generations of women and girls.

This special January 2014 edition of the Global Health Impact Newsletter (subscribe) features 12 stories from 2013 highlighting how MSH is saving lives by strengthening health systems at all levels--from the household to the community to the health facility to national authorities. The stories were selected through an internal storytelling contest (available in print soon).

We are also pleased to share a post from President and CEO Jonathan D. Quick outlining our vision for 2014.

“John” is a healthy 2-year-old, thanks to HIV medication for his mother.Photo credit: Jimmy Felix/SCMS in Haiti.

SCMS and MSH at the forefront of efforts to remove supply chain barriers to the scale up of HIV/AIDS treatment programs

For many of us in the developed world, it is easy to overlook the critical role that well-functioning supply chains play in effective healthcare. When supply chains are operating as they should, we take for granted that the medicines we need will be in stock and available. Yet throughout the developing world, most patients’ access to critical health commodities is much more tenuous; linking medicines to the health professionals that provide treatment and the people who receive care remains a central challenge facing national health systems.

Ensuring that supply chains are sustainable and can tap into high-quality, low-cost medicines, presents an even greater challenge.

Today, as we celebrate International Youth Day and the theme of “Youth Migration: Moving Development Forward,” we are reminded of difficult situations millions of young people experience every day—and of the power young people have to create change in their lives when they connect with their peers.

Adolescents and young men and women need access to quality, affordable reproductive health services. In the developing world, 52 million never-married women, aged 15-24, are sexually active and in need of reproductive health and HIV prevention services and information. Yet, adolescent girls often face greater barriers than adult women in accessing them. In the sub-Saharan Africa region, only 21 percent of married adolescents are using a modern contraceptive method; and the adolescent birth rate in the region is four times the rate in Europe and Central Asia. In the Latin America region, teenagers have doubled their proportion of the fertility rate from 8.5 percent in 1955 to 14.3 percent in 2005, despite a steady decline in overall fertility numbers.

On June 7, Management Sciences for Health (MSH) and partners hosted Dr. Florence Guillaume, the Minister of Health of Haiti, and panelists for a Capitol Hill luncheon on community health workers in fragile states. The day before, MSH hosted Guillaume in Cambridge, MA, for a town-hall style event on improving maternal and child health. Revisit the two events through a "Storify" story of photos, text, and tweets.

Late one April night in 2012, 19-year-old Ilionelle was struggling to give birth at her home in rural northwest Haiti. After several hours, she began having seizures, a clear indication of eclampsia, a severe medical disorder that can lead to the death of the mother and/or baby.

Ilionelle’s situation is not uncommon in Haiti, which has the highest maternal mortality rate in the Western hemisphere with 630 deaths per 100,000 live births. Fortunately, Tilma, the traditional birth attendant helping Ilionelle, quickly identified these life-threatening symptoms and arranged for her transport to Beraca Hospital for emergency obstetric care. After being carried on a stretcher for four hours along a steep and treacherous road, Ilionelle arrived at Beraca Hospital where she safely delivered a healthy baby boy. “If it wasn’t for Tilma, both my son and I could have died,” Ilionelle said.

Tilma is among thousands of Haitians working to improve their nation’s health after recent years of misfortune.

In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system. Haiti’s fragile population is further plagued by the highest HIV prevalence in the Western Hemisphere at 1.9 percent, which translates to roughly 120,000 HIV-positive individuals and 93,000 children who have lost their parents to AIDS (UNAIDS, 2011).

Each year over 10 million men, women, and children in developing countries die as a result of our collective failure to deliver available safe, affordable, and proven prevention and treatment. A recent analysis of innovations in products and practices for global health, from the Hepatitis B vaccine to use of skilled birth attendants, revealed virtually none of these life-saving interventions reaches much more than half their target population—even after as many as 28 years of availability. This reflects a vast gap between knowledge and action in global health.

Successful Health Systems Innovations

Low- and middle-income countries (LMIC) benefit from continued innovations in health products and health practices, such as use of misoprostol to prevent post-partum hemorrhage, and technologies such as internet-based mHealth applications to protect the poor from catastrophic health expenditures. To ensure such innovations achieve large-scale, widespread coverage, they must be accompanied by much more effective health systems innovations.